Age

Toddlerhood (13-35 months)

Early Childhood (3-5 years)

Middle Childhood (6-11 years)

Adolescence (12-18 years)

Abstract

Our proposal addresses MCHB/HRSA's priority interest in autism service systems and
infrastructure. The issue of concern is that families with children with autism have a
more difficult time finding and paying for services than other families with children with
special health care needs. To what extent is state insurance policy on autism associated
with better access for children with autism? The proposed study seeks to answer this
question through three specific aims: 1. Assess whether access to care for children with
autism varies across states, 2. Assess the extent that state characteristics, such as
insurance policy on autism, enhance access to care for children with autism, and 3.
Indentify the states that have achieved the best access to care for children with autism for
future study. Data from the 2005-2006 National Survey of Children with Special Health
Care Needs (NSCSHCN) will be augmented with data on state autism insurance policy
features to allow an analysis of the association between state autism policy and access to
care for families with children with autism compared to families with children with other
special health care needs. The NSCSHCN is a complex, multistage sample of children
with special health care needs, including autism, representative of the nation as well as
each state and the District of Columbia. Multilevel regression will be used to correct for
the nonindependence of family-level observations nested within states, and assess the
contribution of family and state variables on access to care.
This will be the first national study of autism policy tied to outcomes for families. The
proposed study can move the field forward in a short timeframe by filling in the big
picture of autism state policy impacts. Findings identifying state policies associated with
better access to care for children with autism, and those states where the constellation of
policies is associated with better access. Findings generate hypotheses for future studies
to determine why these policies work. The need to develop our understanding of what
insurance policies work for autism is pressing. The Autism Treatment Acceleration Act
(ATAA), recently introduced in the US Congress, calls for private insurance coverage of
the diagnosis and treatment of autism. The proposed study provides important insights
for policy design and future study of access to care for children with autism.